AAP Issues Guidelines For Care of Infants in Planned Home Births

4/29/2013For Release: April 29, 2013

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​​​​​​Although still uncommon, the rate of home
births has increased during the past several years in the U.S. In a new policy
statement, “Planned Home Birth,” in the May 2013 Pediatrics (published online
April 29), the American Academy of Pediatrics (AAP) makes recommendations for
the care of infants born in a home setting. Regardless of the circumstances of
the birth, including location, every newborn infant deserves health care that
adheres to AAP standards. The AAP concurs with the recent statement from the
American College of Obstetricians and Gynecologists (ACOG) that the safest
setting for a child’s birth is a hospital or birthing center, but recognizes
that women and their families may desire a home birth for a variety of reasons.
Pediatricians should advise parents who are planning a home birth that AAP and
ACOG recommend only midwives who are certified by the American Midwifery
Certification Board. There should be at least one person present at the delivery
whose primary responsibility is the care of the newborn infant and who has the
appropriate training, skills and equipment to perform a full resuscitation of
the infant. All medical equipment, and the telephone, should be tested before
the delivery, and the weather should be monitored. A previous arrangement needs
to be made with a medical facility to ensure a safe and timely transport in the
event of an emergency. AAP guidelines include warming, a detailed physical exam,
monitoring of temperature, heart and respiratory rates, eye prophylaxis, vitamin
K administration, hepatitis B immunization, feeding assessment,
hyperbilirubinemia screening and other newborn screening tests.If warranted, infants may also require
monitoring for group B streptococcal disease and glucose screening.
Comprehensive documentation and follow-up with the child’s primary health care
provider is essential.

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The American Academy of Pediatrics is
an organization of 60,000 primary care pediatricians, pediatric medical
subspecialists and pediatric surgical specialists dedicated to the
health, safety and well-being of infants, children, adolescents and
young adults. (www.aap.org)